Vol. 342 No. 9
asked the Minister for Health the number of new cases which have come before the independent medical group in respect of alleged damage suffered by children as a result of whooping cough vaccine since the report was furnished to him by the group in June 1982.
7.
asked the Minister for Health whether any of the parents who are entitled to seek payment of the ex gratia sum of £10,000 as a result of their child being adjudged to have suffered damage as a result of the administration of whooping cough vaccine have taken up any such payments.
8.
asked the Minister for Health if he will introduce legislation to provide a formal statutory procedure whereby parents can claim compensation for brain damage caused to their children as a result of the administration of whooping cough vaccine.
9.
asked the Minister for Health if he will establish a formal independent appeals tribunal to which parents whose children have been adjudged not to have suffered brain damage as a result of the administration of whooping cough vaccine may appeal and ensure that all parents appealing to such a tribunal have full access to all reports used in reaching the original decision.
I propose to take Questions Nos. 6 to 9, inclusive, together.
A total of 36 additional applications has been submitted for consideration by the Expert Medical Group since the announcement of the group's findings in July 1982.
Two sets of parents have accepted the ex gratia payments offered.
I do not consider that it would be appropriate to establish a formal statutory procedure in respect of compensation for probable brain damage arising from whooping cough vaccination. Nor do I accept the need for, or the desirability of, a system to appeal against the opinions of the Expert Medical Group.
The group were appointed to give an expert, independent view on the persons who presented themselves to it and their opinions were made on the balance of probabilities in each case. The procedure adopted by the group is considered to have been comprehensive enough to have enabled them to draw conclusions in respect of each applicant, on the balance of probabilities.
I am not in a position to release the individual reports. Many of the documents contained in the reports are of a sensitive and confidential nature and were furnished to the group purely for the purposes of its investigation.
The Minister indicated that there have been 36 additional children referred to the medical group. Is this since July 1982? Is the Minister in a position to indicate what the ages of these children are and, if not, in a position to indicate how many of the 36 were children born after 1975?
I do not have the specific ages concerned at this stage. I can possibly, bearing in mind the confidentiality of the matter and even bearing in mind that the Deputy may be active in another capacity, send him some broad profile of the information available to my Department but in relation to the 54 cases I do not have the age profile of the persons concerned.
Can the Minister indicate how many children, on the basis of the report given by the independent medical group, are actually entitled to the ex gratia payment of £10,000 and can he indicate the reason why the remaining children who are so entitled have not claimed the sum or been paid the sum and why only two sets of parents have sought this payment?
The medical group was probably the most expert group established in any European country. That expert group, as the Deputy knows, was established for the purpose of examining persons who, it was claimed, had been permanently damaged by whooping cough vaccination prior to the establishment of the monitoring system. Originally a total of 54 cases were presented for examination by the group. The group decided that 14 of the 54 were probably damaged by vaccine. The Government then decided to make an ex gratia payment on the clear basis that no liability was being accepted by the State. Of the 36 new claims 26 have already been examined by the expert group and the remainder should be dealt with by the end of June. The group will then submit their report to me. At this stage it seems likely that very few will be considered as probable cases of vaccine damage. As Deputies will appreciate, there is a great deal of subjective analysis and monitoring and assessment done and in such a highly subjective area of analysis by the medical expert group at this stage I do not want to go any further.
The Minister has clearly indicated that 14 children at least have been adjudged by the expert medical group as having suffered damage and compensation has been paid to only two sets of parents. Is the Minister in a position to indicate the reason why 12 sets of parents have not sought this payment and can the Minister confirm that the reason is the restrictive nature of the conditions imposed by his Department on parents who accept such payment?
The offer was made to the parents concerned on the clear understanding that my Department could not and would not and indeed will not accept liability in relation to the matter. While I appreciate the enormous distress and disabling effects of what occurred in relation to that vaccine damage, the scheme was announced by my predecessor and I have some reservations as to whether there should have been a scheme of compensation at all and the word "compensation" being used when, in fact, it was an ex gratia payment. It is the privilege of the 12 sets of parents concerned to accept or not to accept. I cannot force them to accept the ex gratia payment.
Would the Minister not agree that the conditions applied by his Department to the making of this payment are a good deal more restrictive than the conditions applied in identical circumstances under legislation passed in the United Kingdon to the making of identical payments and could the Minister explain the reason why his Department insist on these restrictive conditions?
I would not accept it. One must remember that in the UK there was not, as such, an expert examining group and they did not go through individual case studies with the intensity of examination and care which the Irish group did. They worked on the basis of a series of submitted reports rather than individual examinations including, as occurred in Ireland, a great deal of clinical examinations and X-ray work and so on on each individual claim. That did not occur at all in the UK. The UK scheme was not a compensation scheme either. The basic ex gratia payment is no more than a payment to ease the difficulties of those who are suffering from vaccine damage. I would certainly hold the view, having examined the matter very carefully, that the Irish system of assessment and the care taken by the Department of Health here is, if anything, superior to that of the UK and to any of the other EEC Member States.
Would the Minister——
I have to go to the other side of the House.
Would the Minister be prepared to make a statement showing the very low incidence of possible brain damage as a result of vaccine because many people believe that the possibility of this got untoward publicity in the past and as a consequence many mothers were afraid to get children vaccinated? Would the Minister be prepared to make a statement emphasising the very low incidence of this condition? I believe mothers need reassurance.
I would share the view of the Deputy in this regard. It must be borne in mind that whatever the tragedy that occurred the person at the time received vaccination for his or her protection against the very distressing and often disabling effects of the infectious disease concerned. Whooping cough can have the most severe complications such as convulsions and pneumonia and can even result in death, whereas of the 40 cases examined 14 were agreed but the incidence of effect is extraordinarily low and the balance of advantage to mothers of having their children vaccinated is overwhelmingly in favour of vaccination irrespective of the past probability or the current possibility of children being affected.
Would the Minister not agree that the secrecy that has surrounded this whole issue and the manner in which it has been dealt with by his Department and himself and his predesessors has given rise to suspicion which has resulted in a large number of parents not agreeing to their children being vaccinated in circumstances where children are not at risk? This is an ongoing problem and 36 new cases have referred to the medical group since June of this year. Would the Minister not agree that legislation is desirable in the light of the fact that this matter has been dealt with in a more comprehensive way in England, France, Germany, Denmark, Sweden and a number of other countries?
I do not accept that there are statutory schemes in operation in other countries as such. I have examined the credentials as a lay person. I have gone through the files. I have done a good deal of work on it, as has my colleague Deputy O'Brien. We both considered this matter at great length together with the officials of the Department of Health. The expert medical group established in 1977 went to enormous trouble and took a great deal of care. There is legislation in Denmark. There is the 1961 Act in Germany. In France a public health code was enacted. In recent years we have attempted to come to grips with the situation. Threats and legal action have been referred to. The officials of the Department, the expert group and my predecessor bent over backwards to weigh the balance of probability or doubt in favour of the persons concerned.
Ceist 10. We cannot have a detailed cross-examination which could last for a day and a half.
Would the Minister agree that there have been a considerable number of unjustified and fallacious claims for compensation in relation to the toxic effects of the vaccine?
I hold the view very strongly that no amount of money would compensate for the trauma of the appalling effects visited on the tragic group involved. It is important to bear in mind that cash compensation does not change the situation. In some respects — I do not suggest this in relation to the parents concerned — in some of the representations I have received it may appear that there is an excessive preoccupation with cash compensation. My Department endeavoured to give every special facility to the 54, the 14 and the new 36. We have tried to provide special care, treatment and facilities for all persons who suffered this tragedy. In that regard the State more than meets the obligation arising from the whooping cough vaccination tragedy. In our publicity we stress that vaccination is an imperative in the case of infectious diseases and the prevention thereof.
I will accept one final supplementary from Deputy Shatter, who put down the four questions.
Would the Minister not agree that, even in the context of the parents whose children have been adjudged not to have been affected by the vaccine, the claims made by all of them were bona fide and were not made fallaciously or in an attempt to seek money? Would the Minister accept that the concern of the parents whose children have been adjudged to be unaffected by the vaccine is that the information upon which the expert medical group made their decision has not been made available to them? They feel they are entitled to have this information made available to them. Would the Minister not agree that the information should be made available to the parents to remove suspicions or worries as to the correctness of the decisions made? In the circumstances would the Minister consider establishing an appeals tribunal such as exists in other member states of the EEC for dealing with this issue?
That is repetition.
There is a major problem involved here. I have been very circumspect. I have used the phrase "as a lay person". Sensitive and confidential information is in the possession of the expert medical group. The case histories concerned, the detailed inquiries they made from family doctors, and which they had to make in order to assess those cases, and the detailed inquiries they made from paediatricians and others with a knowledge of each individual case are confidential to the groups concerned. If each parent has to be presented with all the assessments and the criteria used in relation to each individual claim, we are entering into a major area of medical ethical assessments. I have examined the situation very carefully, as did my predecessor. Deputy Woods and I came to the conclusion that it would not be in the best interests of everybody concerned that all of the information on the case histories should be disclosed.
